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Individual

MRS. VIRGINIA SOURIS KEATING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
3715 NORTHSIDE PKWY NW, 400 NORTHCREEK, STE. 150, ATLANTA, GA 30327-2882
(404) 233-5252
(404) 233-0490
Mailing address
4035 WHITEWATER CREEK RD NW, ATLANTA, GA 30327-3946
(404) 233-5252
(404) 233-0490

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
RN181526
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN181526
PROFESSIONAL LICENSE NP-C
GA
Enumeration date
01/13/2016
Last updated
01/13/2016
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